Pain Management

COCCYGEAL BLOCKS

Injections are into the joint between the top of the triangular bone at the base of the spine and the base of the tailbone. When hard-to-pin-down lower back pain is accompanied by a dull ache high in the rectum, this kind of injection may confirm or disprove whether the patient’s pain is caused by coccydynia, a condition caused by impact to the tailbone.

DISC NUCLEOPLASTY

A minimally invasive procedure for patients who have lower back and/or leg pain caused by a herniated disc, and who have not responded to any of the nonsurgical options.

DISCOGRAPHY

An injection technique used to evaluate patients with back pain who have not responded to any of the conservative treatment options. Discography is often used for planning prior to procedures such as Intradiscal Electrothermal Therapy (see below) or a lumbar fusion by a spinal surgeon.

EPIDURAL STEROID INJECTION

Injections are into the spinal canal between the membrane surrounding the nerve roots and the interior surface formed by the vertebrae.

FACET JOINT BLOCKS- CERVICAL, THORACTIC, LUMBAR

Injections are into the facet joints — small joints at each segment of the spine that provide stability and help guide motion. Pain in facet joints is often because of arthritis of the spine, a back injury or stress to the back.

INTERCOSTAL NERVE BLOCK

Injections are under the targeted rib and help relieve pain in the chest caused by shingles or a post-surgical chest scar.

INTRADISCAL ELECTROTHERMAL THERAPY (IDET)

A minimally invasive procedure for patients with chronic lower back pain who have not responded to more conservative treatments, and whose pain is thought to be caused by nerve fibers that have grown from their normal location in the outer layers of a spinal disc to inside the disc.

KNEE, HIP, & SHOULDER BLOCKS

Injections are often an effective approach to addressing pain and inflammation without surgery. For minor blocks, numbing medication and corticosteroids are injected into targeted areas using ultrasound for guidance.

LATERAL FEMORAL CUTANEOUS NERVE BLOCKS

Injections are into the nerve at the top lateral part of your thighs on each side. When there is tingling, numbness or a painful stinging sensation in the front or outer parts of the thighs, the cause is often an injury or dysfunctional pressure to the area.

LUMBAR & STELLATE GANGLION SYMPATHETIC BLOCKS

Injections are in the front of the neck, either to the left or right. Injuries to the shoulder, arm, wrist or hand can cause odd, burning pain lower in the body.

MINIMALLY INVASIVE LUMBAR DECOMPRESSION

A minimally invasive procedure to remove bits of bone and tissue that are causing narrowing of a patient’s spinal canal — a condition called LSS (Lumbar Spinal Stenosis), which is characterized by pain that increases when a patient walks or stands, then subsides when sitting or bending forward.

OCCIPITAL NERVE BLOCK

Injections are into the back of the head, just above the neck. Pain concentrated at the back of the head, including certain types of tension headaches and migraine headaches, often respond to this treatment.

PIRIFORMIS MUSCLE BLOCK

Injections are into the muscle attached to the side of the flat bone at the base of the spine just above the tailbone. Tightness in this muscle can cause sciatica, which is pain down the back of the leg. There may also be pain symptoms in the hip or lower back, and possibly in the groin, genitals and rectum.

SACROILIAC JOINT BLOCK

Injections are into either the left or right joint. The sacroiliac joints lie next to the spine and connect the tailbone to either side of the hip. Women are more likely to develop this dysfunction, with pain on one side of the lower back, radiating down the leg to the knee, ankle or foot.

SPINAL CORD STIMULATION TRIAL

Used for patients who have spinal lesions that cannot be treated surgically. Treatment includes a short trial conducted with a temporary stimulator to see whether or not this is a good option for the patient.

TRIGGER POINT INJECTIONS

Injections are into knots of muscle that form when muscles will not relax, causing pain.